tbuckley/cabot-search huggingface dataset:
Abstract P604: Acceptability of a Newly Developed Southern Dietary Approaches to Stop Hypertension Diet Among Heart Failure Patients in the South: A Sensory Evaluation
Authors: Rupal Trivedi-Kapoor, Kip Hardy, Michael Bacha, Ginnefer O Cox, Randall L Tackett, Henry N Young, Elisabeth L Sattler
Journal: Circulation (2023)

Introduction: Despite known benefits of the DASH diet on cardiometabolic outcomes, adherence rates have been low among heart failure (HF) patients in the Southern US. Objective: To 1) use sensory evaluation methods to assess the acceptability of a newly developed Southern DASH diet among HF patients in the South, and 2) assess its associations with participants’ demographic and health characteristics. Methods: Through collaborative efforts with dietetics and culinary experts, and by using qualitative data on dietary preferences among HF patients in the South, we developed a new 14-day Southern DASH diet meal plan. Each day of the meal plan met NHLBI standards for DASH diet serving sizes based on 2000 kcals/day and limited sodium to 2300 mg/day. The study assessed acceptability of 4 days’ worth of breakfasts, lunches, snacks, and dinners. Using a 9-point hedonic scale, participants rated the overall liking (OL), appearance, flavor, texture, and preparation intent (PI) for each recipe. Demographic and health characteristics were obtained by survey. We conducted Kruskal-Wallis tests with a Bonferroni adjustment to assess acceptability differences between Southern DASH diet days. Mann-Whitney U tests were performed to assess relationships between acceptability and participants’ characteristics. Results: Sample size calculations were met (n = 35 participants enrolled). The mean (SD) age was 67.2 (9.5) years, 37.1% were female, and 14.3% African American. Using industry standards (OL ≥7), 3 out the 4 evaluated days were highly accepted. Day 3’s OL, flavor, texture, and PI, and Day 4’s ratings for flavor were rated significantly higher than those for Day 2 (Table 1). Day 3’s OL rating was significantly higher among those who received nutrition education for managing HF than those who did not ( U = 213.0, p-value = 0.009). No significant differences were determined between OL and race. Conclusions: A newly developed Southern DASH diet was largely accepted among HF patients in the South and supports targeted HF management efforts.
Abstract P132: Application of Life’s Essential 8 to Assess the Status of Cardiovascular Health Among 4-to-6-year-old Children in the Healthy Start Study
Authors: Wei Perng, Izzuddin Aris, Katherine Sauder, Dana Dabelea
Journal: Circulation (2023)

Introduction: The American Heart Association recently put forth the Life’s Essential 8 (LE8) scoring system to assess cardiovascular health (CVH) status based on four health factors: body mass index [BMI], fasting glucose, non-high-density-lipoprotein cholesterol, and blood pressure; and four behavioral factors: first- and second-hand nicotine exposure, diet quality, physical activity, and sleep duration. Few studies have applied LE8 to assess CVH in children, and little remains known about concordance in CVH status based on LE8 vs. Life’s Simple 7 (LS7), the prior scoring system that employed different definitions and thresholds for defining CVH. Objectives: (1) Apply LE8 to assess prevalence (%) of low, moderate, high, and optimal CVH in diverse 4-to-6-year old children; (2) Compare concordance in CVH status categories based on LE8 vs. LS7. Hypothesis: Use of LE8 will yield at least 20% prevalence of high and optimal CVH; this prevalence will be higher than estimates based on LS7. Methods: Using data from 305 children in the Healthy Start cohort, we applied the LE8 scoring system to derive a composite CVH score for each child and estimated % low (LE8 CVH score &lt;50 of 100 possible points), moderate (score 50-&lt;80), high (score 80-&lt;100), and optimal CVH (score=100). Next, we applied the LS7 scoring system to estimate % of participants in the same four categories (low CVH: LS7 CVH score &lt;7 of 14 possible points; moderate CVH: score 7-&lt;10.5; high CVH: score 10.5-&lt;14; optimal CVH: score=14). Finally, we assessed concordance in prevalence across CVH status categories for LE8 vs. LS7 using the Wald chi-squared test, and calculated the correlation between continuous CVH scores based on LE8 and LS7. Results: The average age of participants was 4.7±0.6 y. Forty-five percent were female (n=136); 62% identified as white, 23% as Hispanic, and 12% as Black. No children had low or optimal CVH with either scoring system. However, prevalence of high CVH was higher based on LE8 than LS7 (40.6% vs. 33.4%; P &lt;0.0001). Twenty-one percent of participants had high CVH according to both scoring systems. We observed a moderate positive correlation (Pearson R 2 =0.55) between continuous CVH scores for LE8 and LS7. Conclusions: While no participants had low or optimal CVH in Healthy Start during early childhood, LE8 yielded a higher prevalence of high CVH than LS7. Future studies are warranted to assess determinants and consequences of CVH status during this life stage.
Abstract P430: Role of Cystatin C-based Estimated Glomerular Filtration Rate for Direct Oral Anticoagulant Dosing in Patients With Atrial Fibrillation
Authors: Jung-Im Shin, Yunwen Xu, Shoshana Ballew, Alessandro Bosi, Paul Hjemdahl, Morgan Grams, Josef Coresh, Lesley Inker, juan jesus carrero
Journal: Circulation (2023)

Introduction: Renal dose adjustment is imperative to appropriate direct oral anticoagulant (DOAC) prescribing among patients with atrial fibrillation (AF). Serum creatinine is routinely used to estimate GFR (eGFRcr) in clinical practice, but eGFRcr may be less accurate in certain settings. It is unknown whether other kidney function biomarkers, like cystatin C, is helpful to guide DOAC dosing. Hypothesis: Appropriate DOAC dosing by eGFRcr but supratherapeutic dosing by cystatin C-based eGFR (eGFRcys) is associated with bleeding, compared to appropriate dosing by both eGFRcr and eGFRcys. Methods: We conducted observational study from the SCREAM project, a healthcare utilization cohort of Stockholm, Sweden, during 2006-2018. We identified patients with AF on DOACs who had creatinine and cystatin C measured on the same day. We calculated eGFRcr with the 2021 Chronic Kidney Disease (CKD)-EPI and eGFRcys with 2012 CKD-EPI cystatin C equations. We estimated defined daily dose consumed per day and considered &lt;0.8 as a reduced dose. We separately classified supratherapeutic, subtherapeutic, and appropriate dosing by eGFRcr and eGFRcys, and examined the bleeding risk using Cox regression. Results: Among 5427 AF patients on DOACs, mean age (SD) was 76 (9) years and 43% were women. Compared to eGFRcr, eGFRcys identified more patients with CKD (61% for eGFRcys &lt;60 ml/min/1.73 m 2 vs. 35% for eGFRcr &lt;60 ml/min/1.73 m 2 ), as well as more patients with supratherapeutic dosing (7.9 vs. 2.4%). Among 3064 patients who were classified as appropriate dosing by eGFRcr, 312 (10.2%) were reclassified as supratherapeutic dosing by eGFRcys and had a higher risk of bleeding (hazard ratio=1.58, 95% CI: 1.03-2.42), compared with those who were classified as appropriate dosing by both eGFRcr and eGFRcys ( Table ). Conclusions: Appropriate DOAC dosing by eGFRcr but supratherapeutic dosing by eGFRcys was associated with a higher risk of bleeding. The findings suggest that eGFRcys may inform decisions on DOAC dosing.
Abstract 63: Life’s Essential 8 and Life Expectancy Free of Cardiovascular Disease, Diabetes, Cancer, and Dementia in Adults
Authors: Xuan Wang, Hao Ma, Xiang Li, Yoriko Heianza, Joann E Manson, Oscar H Franco, Lu Qi
Journal: Circulation (2023)

Background: Average life expectancy has increased substantially in recent decades in most developed countries; however, a sizable proportion of the increased life expectancy is spent in suboptimal health. Hypothesis: We investigated whether levels of cardiovascular health (CVH), estimated by the American Heart Association’s newly released Life’s Essential 8 (LE8) metrics, was associated with life expectancy free of major chronic disease including cardiovascular disease (CVD), diabetes, cancer, and dementia, in UK adults. Methods: This study included 136,599 adults in the UK Biobank who were initially free of CVD, diabetes, cancer, and dementia and had complete data on LE8 metrics. Eight components were used to create the LE8 score, including diet, physical activity, tobacco/nicotine exposure, sleep, body mass index, non-high-density-lipoprotein cholesterol, blood glucose and blood pressure. Multistate life tables were applied to calculate the total life expectancy and years lived with and without diseases (CVD, diabetes, cancer, and dementia) according to adherence to the levels of CVH (poor, intermediate and ideal) in men and women. Results: Compared to those with poor CVH (referent), men and women with ideal CVH had an average 5.2 (95 % CI, 3.6 to 6.8) and 6.3 (95% CI, 4.9 to 7.9) more years of total life expectancy at age 50, respectively. The percentage of life expectancy free of chronic diseases out of total life expectancy was 75.9% for men and 83.4% for women who had ideal CVH, compared to 64.9% and 69.4%, respectively, for those with poor CVH. Moreover, we found that disparities in disease-free years related to low socioeconomic status were substantially narrowed by adhering to ideal CVH in both men and women. Conclusions: Adherence to ideal CVH, evaluated with the LE8 metrics, is associated with markedly extended life expectancy and more years lived free of major chronic diseases, as well as narrowing of socioeconomic health inequalities, in both men and women.
Abstract P539: Association of Metabolic Syndrome With Angina: Results From NHANES 2009 - 2020
Authors: Olayinka Agboola, Yu Niu, Valentine Njike
Journal: Circulation (2023)

Background: Metabolic syndrome (MetS) is a known risk factor for cardiovascular disease. However, there are limited data on its association with angina. We assessed the association of MetS with angina in a nationally representative sample of noninstitutionalized Americans. Methods: We combined data from five National Health and Nutrition Examination Survey (NHANES) data cycles from 2009 to 2020. We included participants aged 40 years or older. MetS was defined using the AHA/NHLBI criteria. Angina was ascertained based on the ROSE angina questionnaire. Multivariable logistic regression models adjusting for age, race, and sex were used to assess the association between MetS and angina. Results: Among the 21752 participants included in the analysis, 11381 (52.3%) met the criteria for MetS. Nine hundred and fifty-nine participants (4.4%) had angina. Angina was more prevalent among those with MetS than those without MetS (5.9% vs. 2.8%; p = &lt;.0001). Compared with participants without MetS, Those with MetS were more than two-fold more likely to suffer from angina (adjusted Odds Ratio, 2.06; 95% CI 1.76-2.40; p = &lt;.0001). Conclusion: From this nationally representative sample, participants aged 40 years or older with MetS were more likely to suffer from angina compared with those without MetS. Suggesting MetS as an independent risk factor of coronary artery disease.
Abstract P354: Trends in Malignancy and Cardiovascular Disease Related Mortality in the United States
Authors: Ramzi Ibrahim, Soumiya Ravi, Mohammed Salih, Adam Habib, Abdulla Alabagi, Vikram Singh, Simar Singh, Jonathan Ferng, Justin Z Lee
Journal: Circulation (2023)

Introduction: In the United States (US), malignancy and cardiovascular disease (CVD) make up the majority of the burden of chronic diseases, leading to greater morbidity and mortality. As the general population grows older, the prevalence of these two disease entities are likely to increase. Efforts in cardio-oncology have been focused on disease prevention and treatment, however, little is known about existing disparities in this population. Hypothesis: Unequivocal burden of CVD-related mortality exists among certain gender, racial, and geographic subgroups. Methods: Data was obtained from the CDC Wide-ranging Online Data for Epidemiologic Research database using death certificate information from the National Vital Statistics system. All CVD-related death (I00 - I78) as the underlying cause of death in individuals with malignancy (C00 - C97) as the multiple causes of death were queried from 1999 - 2020. Underlying cause of death was defined as the disease that directly led to death and the multiple causes of death were defined as the diseases that contributed to death. Quantified measures included age-adjusted mortality rate (AAMR) per 100,000 population, 95% confidence intervals, and average annual percentage change (AAPC). Joinpoint regression (National Cancer Institute) was utilized for trend analysis and AAPC calculation. Results: There was a total of 595,446 deaths between 1999 and 2020. The AAMR in 1999 was 24.85 which decreased to 12.811 by 2020 (p &lt;0.05), with an AAPC of -3.1%. Males (23.14) had a higher AAMR compared to females (11.05) (p &lt;0.05), and AAPC for both males and females were -3.4%. AAMR was disproportionately higher in non-Hispanic populations (16.26) compared to Hispanic populations (9.17) (p &lt;0.05), with similar AAPC (-3.1% and -3.0%, respectively [p &gt;0.05]). Black individuals (18.87) had the highest AAMR, followed by White individuals (15.81), American Indian/Alaska Native individuals (9.40), and Asian/Pacific Islander individuals (8.26) (p &lt;0.05). All AAPC for the racial subgroups were similar (-3.3%, -3.1%, -2.7%, and -4.1%, respectively [p &gt;0.05]). Non-metro regions (17.20) had higher AAMR compared to metro regions (15.54) (p &lt;0.05) with an AAPC of -2.4 and -3.3%, respectively (p &gt;0.05). The Northeast (17.93) had the highest AAMR, followed by similar AAMR in the Midwest (16.44) and West (16.30) regions, and then South regions (13.98) (p &lt;0.05). AAPC was similar among all US census regions (-3.6%, -3.3%, -3.4%, and -2.8%, respectively [p &gt;0.05]). Conclusion: Even with decreasing rates of AAMR from 1999 to 2020, there remains a disproportionate burden of AAMR among gender, racial, and geographic subgroups. Continued efforts targeted at mitigating CVD-related mortality in patients with underlying malignancy is warranted.
Abstract P410: Spontaneous Coronary Artery Dissection and Intervention With Percutaneous Coronary Intervention (PCI): A Population Based Study 2016-2019
Authors: Yaser Khalid, Kirti Dasu, Rohan Umrani, Trinava Roy, Neethi Dasu, Bhavana Kadiyala
Journal: Circulation (2023)

Background: Spontaneous coronary artery dissection (SCAD) remains an important cause of myocardial infarction. A paucity of data exists regarding optimal management of SCAD due to lack of randomized trials comparing medical therapy and revascularization strategies. Methods: Data were extracted from the National Inpatient Sample (NIS) 2016-2019 Database. The NIS was searched for hospitalizations for adult patients with SCAD as principal discharge diagnosis with and without intervention with percutaneous coronary intervention (PCI) as secondary diagnosis using ICD-10 codes. The primary outcome was inpatient mortality. Multivariate logistic and linear regression analysis was used accordingly to adjust for confounders. STATA software was used for analysis. Results: 2,400 patients who had SCAD were divided into those that had PCI versus those who did not-- followed by matching. Majority of the patient population was noted to be females (76.9%) and mean age was a 54.63 years. The adjusted odds ratio (OR) for inpatient mortality for SCAD with PCI intervention showed significantly reduced mortality (OR 0.32, p&lt;0.01), which was statistically significant. Hospital length of stay (LOS) was less (-1.23 days, p&lt;0.04) and total hospital charges were lower (-$3,697.02, p&lt;0.03) in this patient population. The only independent positive predictor of increased mortality for the SCAD and PCI intervention group was acute kidney injury (AKI) (OR 4.99, p&lt;0.001). Independent positive predictors of hospital LOS were the following: cardiogenic shock (4.14 days, p&lt;0.01), AKI (4.99 days, p&lt;0.01), ventricular arrhythmias (3.53 days, p&lt;0.01), and systolic heart failure (2.84 days, p&lt;0.03). Independent positive predictors for total charges were the following: cardiogenic shock ($108,113.9, p&lt;0.015), ventricular arrhythmias ($109,009.6, p&lt;0.04), AKI ($107.635.7, p&lt;0.003), atrial flutter ($134,619.3, p&lt;0.042). Conclusion: Previous studies showed that the majority of patients with SCAD except those with high risk should have a conservative revascularization strategy. Our study shows decreased mortality, hospital LOS, and total charges for patients with SCAD who had intervention with PCI. Randomized clinical trials will need to further examine the role of PCI for SCAD in different populations.
Abstract P424: Associations of Taste-Related Genes With Empirical Dietary Patterns Among Community-Dwelling Adults - The Framingham Heart Study
Authors: Julie E Gervis, Jiantao Ma, Kenneth Chui, Alice H Lichtenstein
Journal: Circulation (2023)

Background: Understanding the genetic contribution to food choices and intake is critical for the development of effective precision nutrition guidance. Recent findings by our lab suggest that genetic variants (SNPs) related to bitter and umami taste perception are differentially associated with food group intakes. The aim of this study was to examine the associations of bitter- and umami-related SNPs, combined as polygenic taste scores, with overall dietary patterns. Methods: Cross-sectional analyses were conducted in 5,817 Framingham Heart Study Offspring (1998-2001) and Third Generation (2002-05) participants (mean age ± SD: 50 ± 14 years; 54% female). Weighed polygenic taste scores were derived using SNPs identified from prior genome-wide association studies for taste perception (11 SNPs: 9 bitter and 2 umami). Higher scores indicated more alleles for higher taste perception. Empirical dietary patterns were derived using Principal Component (PC) analysis with food groups tabulated from food frequency questionnaires. Associations were assessed using linear mixed effects models with FDR adjustment. Results: Three dietary patterns were identified, explaining 32% of total variance in dietary intake: a vegetables, fruits, legumes, and fish pattern (Prudent); a refined grains, sweets, salty foods, and pizza pattern (Western); and a liquor, beer, and wine pattern (Alcohol). On average, after adjusting for age, sex, genetic PCs and energy intake, higher umami polygenic taste scores were associated with lower adherence to the Prudent dietary pattern (OR [95% CI] for upper vs. lower tertial of dietary pattern adherence scores per additional allele for higher umami perception: 0.87 [0.79, 0.97]; P = 0.01). Subsequent analysis at the SNP-level identified one umami-related SNP (rs7691456_T) independently associated with lower Prudent dietary pattern adherence ( P = 0.009), potentially driving the observed association. Both associations remained significant after additional adjustment for smoking, physical activity, and BMI. No significant associations were identified for bitter-related genes and dietary patterns. Conclusions: Among community dwelling adults, higher genetic predisposition to perceive umami was associated with lower adherence to a Prudent dietary pattern, suggesting the potential benefit of leveraging knowledge of taste-related genes in precision nutrition.
Abstract P125: Patterns in Timing of Energy Intake and the Impact on Fat Mass in Adolescents
Authors: Jessica Decker, Babette Zemel, Jonathan Mitchell
Journal: Circulation (2023)

Introduction: Pediatric obesity is excessively high, tracks into adulthood, and increases the risk of multiple chronic diseases (e.g., heart disease). There are dietary guidelines to help prevent childhood obesity, but they do not account for the timing of energy intake, which may be associated with obesity, independent of diet content. We aimed to determine: 1) energy intake timing patterns in adolescents, 2) if energy intake timing patterns differed by sociodemographic factors, and 3) if energy intake timing patterns associated with obesity-related outcomes. Methods: The Sleep and Growth Study (S-Grow) assessed diet in adolescents using three 24hr diet recalls in 8 th and 9 th grade. Time-stamped meals were analyzed using Nutrient Data System for Research software. We calculated the average energy (kcal) consumed for two-hour intervals during the 24-hour day (e.g., 00:00-01:59, 02:00-03:59, etc.) and input the 12 energy intake timing variables into a principal component model to identify energy intake timing patterns. Principal components (PC) with an eigen value 1.0 were retained. Linear mixed effect models were used to determine if sociodemographic factors associated with standardized PC loading scores and if the standardized PC loading scores associated with body mass index (BMI) and fat mass index (FMI, measured by dual energy X-ray absorptiometry), adjusting for sociodemographic factors. Results: Five PCs were identified explaining 58.6% of variance in timing of energy intake. Compared to females, male adolescents were more likely to have a higher PC1 score, corresponding to a “low overnight, moderate morning, high daytime and early evening” intake pattern (beta=0.57, 95% CI=0.20, 0.94). Adolescents living in households with $40-69K (compared to &gt;$99K) annual income were more likely to have a higher PC4 score, corresponding to a “high later evening and overnight, moderate morning, low afternoon and early evening” intake pattern (beta=0.44, 95% CI=0.05, 0.83). Adolescents living in households with &lt;$40K (compared to &gt;$99K) annual income were more likely to have a higher PC5 score, corresponding to a “low overnight, high morning, moderate prolonged daytime and late evening” intake pattern (beta=-0.93, 95% CI=-1.66, -0.19). In addition, the PC5 loading score was associated with lower BMI (beta=-1.38, 95% CI=-2.18,-0.58) and lower FMI (beta=-0.94, 95% CI=-1.45,-0.43). Conclusion: We detected distinct energy intake timing patterns in adolescents. Demographic factors were associated with some of the energy intake patterns, and the energy intake pattern corresponding to “low overnight, high morning, moderate prolonged daytime and late evening” (PC5) was associated with obesity-related outcomes. These findings need to be replicated but point to future pediatric dietary guidelines considering the timing of energy intake for obesity prevention.